A variety of surgical procedures have been developed for the treatment of basal joint osteoarthritis (OA—arthritis causing wearing down and changes in joint surfaces) of the thumb. These include ligament (band of tissue that connects bones) reconstruction (repair through rebuilding), metacarpal osteotomy (bone removed or divided), trapezium excision (surgical procedure of hand joint), soft tissue interposition (repositioning) with or without ligament reconstruction, trapeziometacarpal (bones located in hand) arthrodesis (surgical joint immobilization), silicone (polymeric organic compound) arthroplasty (restoration of a joint), hematoma (mass of clotted blood) and distraction (separation) arthroplasty, and total joint arthroplasty. Problems with persistent pain and poor function have been reported for each of these procedures.
Recently, the ARTELON® CMC (carpo-metacarpal) spacer composed of a biodegradable (broken down by body) polycaprolactone-based polyurethane urea has been introduced for the treatment of basal joint osteoarthritis. A three year prospective pilot study demonstrated that all patients treated with the ARTELON® CMC spacer were stable clinically, had no signs of synovitis (inflammation of synovial membrane), and were pain free. (Nilsson, A., Liljensten, E., Bergstrom, C., Sollerman, C. “Results from a degradable TMC Joint Spacer (Artelon) compared with tendon arthroplasty”. Journal of Hand Surgery (Am.), 30:2, 2005 380-389.) However, clinical complications have been reported with the use of this implant, causing many surgeons to abandon its use. A recent case report demonstrated a foreign-body tissue reaction associated the ARTELON® CMC spacer, requiring implant removal and revision with hematoma and distraction arthroplasty. (Choung, E. W., Tan, V. “Foreign-Body Reaction to the Artelon CMC joint Spacer: Case report”. Journal of Hand Surgery (Am.), 33:9, 2008 1617-1620.)
Thus, there is a need for less reactive and smoother surfaced allograft of knee meniscal tissue as an implant will provide improved pain relief and hand function, while reducing complications in patients being treated surgically for osteoarthritis of the thumb.